School of Optometry and Vision Science, UNSW, Australia.
School of Optometry and Vision Science, UNSW, Australia.
Cont Lens Anterior Eye. 2018 Apr;41(2):219-223. doi: 10.1016/j.clae.2017.10.005. Epub 2017 Oct 21.
To report the density and morphology of cells that are analogous to corneal Langerhans cells and their associations in keratoconus.
This prospective cross-sectional study included a convenience sample of keratoconus subjects aged between 18-65 years. Corneal topography, assessment of ocular symptoms, tear variables, corneal sensitivity, in-vivo confocal microscopy were performed. The number of Langerhans cells were manually counted and averaged across three central corneal images. Cell morphology was graded on a 0-3 scale, where grade 3 indicates cells with long visible dendrites. Associations of Langerhans cells with other variables were evaluated using Spearman's correlation.
Twenty-one keratoconus subjects with a mean age of 43±11 years were included. Eighty-one percent of them were males, 48% had mild keratoconus and 52% were contact lens wearers. Langerhans cells were present in the central cornea in 91% of subjects. Median cell density was 15 cells/mm(IQR: 3-21). Cell morphology of grades 2 or 3 (with short or long dendrites) was seen in 71% of subjects. There was a significant association between Langerhans cell frequency and density with male gender (rho and p-values: -0.669, 0.001 and -0.441,0.045) and between Langerhans cell density and nerve fibre tortuosity (0.479,0.028). No significant association observed with age, contact lens wear or ocular symptoms.
Langerhans cells were present in a significant number of subjects suggesting the possibility of inflammation in keratoconus. Based on the association of Langerhans cells with nerve parameters, we propose inflammation as the underlying cause for corneal nerve changes in keratoconus.
报告类似于角膜朗格汉斯细胞的细胞密度和形态及其在圆锥角膜中的关联。
这是一项前瞻性的横断面研究，纳入了年龄在 18-65 岁之间的圆锥角膜患者的便利样本。进行了角膜地形图、眼部症状评估、泪液变量、角膜敏感性和活体共焦显微镜检查。手动计数并平均了三个中央角膜图像中的朗格汉斯细胞数量。细胞形态学评分采用 0-3 级评分，其中 3 级表示具有长可见树突的细胞。使用 Spearman 相关分析评估朗格汉斯细胞与其他变量的关联。
纳入了 21 名平均年龄为 43±11 岁的圆锥角膜患者。其中 81%为男性，48%为轻度圆锥角膜，52%为接触镜佩戴者。中央角膜中存在朗格汉斯细胞的患者占 91%。中位数细胞密度为 15 个细胞/mm（IQR：3-21）。71%的患者存在形态学为 2 级或 3 级（具有短或长树突）的细胞。朗格汉斯细胞频率和密度与男性性别之间存在显著相关性（rho 值和 p 值分别为-0.669，0.001 和-0.441，0.045），与神经纤维扭曲之间存在显著相关性（0.479，0.028）。未观察到与年龄、接触镜佩戴或眼部症状之间存在显著相关性。
大量患者存在朗格汉斯细胞，提示圆锥角膜中存在炎症的可能性。基于朗格汉斯细胞与神经参数的关联，我们提出炎症是圆锥角膜中角膜神经变化的潜在原因。
